超声引导下连续股神经阻滞对膝关节置换术后炎症及氧化应激反应的影响  

The impact of continuous femoral nerve block under ultrasound guidance on postoperative inflammation and oxidative stress response in knee arthroplasty

作　　者：方敏[1] 孙建良 Fang Min

机构地区：[1]浙江大学医学院附属杭州市第一人民医院,310006

出　　处：《浙江临床医学》2024年第2期159-161,共3页Zhejiang Clinical Medical Journal

基　　金：国家自然科学基金资助项目(82271445);浙江省自然科学基金项目(LY21H090005)。

摘　　要：目的旨在分析超声引导股神经阻滞用于膝关节置换术后患者的效果。方法纳入自2019年1月至2022年12月在本院接受全膝关节置换手术的60例患者,随机分为观察组(n=30)和对照组(n=30),分别接受连续股神经阻滞镇痛和静脉自控镇痛。在术后6 h、24 h、48 h时评估视觉模拟评分(VAS)。在术后即刻、24 h、72 h检测血清白介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、超氧化物歧化酶(SOD)、丙二醛(MDA)和脂质过氧化氢(LHP)水平。记录术后72 h内出现的不良反应。结果两组患者的基础资料具有可比性,术后24 h、48 h观察组患者的VAS评分均低于对照组(P<0.05)。术后24 h和术后72 h,观察组血清CRP、IL-6、TNF-α、MDA和LHP水平均显著低于对照组(P<0.05),SOD水平显著高于对照组(P<0.05)。术后72 h内,观察组的不良反应率为3.3%,明显低于对照组的10%。结论超声连续股神经阻滞能有效降低患者术后疼痛,抑制炎症及氧化应激反应。Objective To observe and evaluate the effect of ultrasound guided continuous femoral nerve block on postoperative inflammation and oxidative stress in patients with knee arthroplasty.Methods Sixty patients who underwent total knee arthroplasty surgery at our hospital from January 2019 to December 2022 were randomly divided into the observation group(n=30)and the control group(n=30),receiving continuous femoral nerve block analgesia and intravenous patient-controlled analgesia,respectively.Evaluated the Visual Analogue Score(VAS)for resting and active states at 6 h,24 h,and 48 h after surgery.Serum C-reactive protein(CRP),interleukin-6(IL-6),and tumor necrosis factor(TNF-α),superoxide dismutase(SOD),malondialdehyde(MDA)and lipid hydrogen peroxide(LHP)levels were detected immediately,24 hours,and 72 hours after surgery.Recorded any adverse reactions that occurred within 72 hours after surgery.Results The basic data of the two groups of patients were comparable.The VAS scores of patients in the observation group were lower than those in the control group at 24 and 48 hours after surgery(P<0.05).At 24 hours and 72 hours after surgery,the level of serum CRP,IL-6,and TNF-α,MDA and LHP in the observation group were significantly lower than the control group,while the serum SOD levels were higher.Within 72 hours after surgery,the adverse reaction rate of the observation group was 3.3%.Conclusion Compared with patient-controlled intravenous analgesia,ultrasound-guided continuous femoral nerve for postoperative analgesia in patients with knee arthroplasty can effectively reduce the VAS of patients during rest and activity,and inhibit inflammation and oxidative stress reaction.

关 键 词：膝关节置换 神经阻滞 氧化应激 炎症 疼痛 

分 类 号：R687.4[医药卫生—骨科学]